Robert B. Doherty, BA
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-1687.
Doherty RB. The Supreme Court and the Affordable Care Act. Ann Intern Med. 2013;158:364. doi: 10.7326/0003-4819-158-5-201303050-00018
Download citation file:
Published: Ann Intern Med. 2013;158(5_Part_1):364.
I respectfully disagree with Dr. Vaccarezza's characterization that the uninsured consists of people who could afford coverage but choose to spend money on “nonessential pleasures.” The Kaiser Family Foundation and the Urban Institute report that “the vast majority of uninsured people are in low- or moderate-income families. Individuals below poverty are at the highest risk of being uninsured, and this group comprises 38% of the uninsured population (the poverty level for a family of four was $22,350 in 2011). In total, nine out of ten uninsured people are in low- or moderate-income families, meaning they are below 400% of poverty” (1). These people lack health insurance because their employers don't offer it, and they can't afford to buy it themselves, not because they choose to spend money on something else. Dr. Vaccarezza also says that the Affordable Care Act will lead to “central government making health care–related decisions.” The law expands the federal government's role in subsidizing and regulating coverage, but it mostly closes gaps in the current system of private insurance rather than putting people in a government-run plan. The Congressional Budget Office estimates that by 2022, an additional 11 million people will be enrolled in Medicaid, 25 million will get coverage from private insurers offered through state- or federally administered marketplaces (exchanges), but 157 million will continue to get health insurance from their employers. The number of uninsured persons will be reduced by 30 million (2).
to gain full access to the content and tools.
Learn more about subscription options.
Register Now for a free account.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only